Orthotic brace units are designed to counteract the instabilities resulting from joint and related soft tissue injury. These devices stabilize the joint area and focus joint movement within a defined range of motion. Unwanted motion is reduced or eliminated and the defined movement permits resolution of the joint injury.
Movement at a particular joint can be lost through the development of flexion or extension contractures. Flexion contractures prevent extension of a joint and extension contractures prevent the joint from being fully flexed. These contractures and joint stiffness can result from disuse or neglect of an existing medical problem such as fractures or tears about a joint, vascular problems, neurological problems, surgeries, traumatic injury, illness or the like. Joint contractures develop after surgery, injury, or repair surgery. People develop extension and flexion contractures in any joint including the fingers, wrist, elbow, shoulder, knee and ankle.
These injuries require physical therapy. The therapist traditionally manipulates the joints, uses heat therapy, weights, or serial casting to improve mobility over a joint. This type of therapy requires multiple visits to a physical therapist. Since the therapy is applied to a patient over a visit that is relatively short in duration, the therapist often uses higher forces than what might be best for the patient in order to obtain mobility gains over the period of physical therapy. Complications may occur as a result of the use of high force for brief, repeated periods of time. Further, the gains in mobility during the physical therapy visits are partially lost during the interval between visits when the joint is no longer subjected to extension or flexion tension.
Spring-biased splints are also commonly used to treat flexion and extension contractures in addition to, or as an alternative to physical therapy sessions with a professional therapist. These devices provide a directional force at a joint. The devices provide tension at the point of flexion or extension to gently and continuously urge the joint into a wider range of motion. There are a number of spring-biased splints in the prior art. Examples of these splints are described in U.S. Pat. Nos. 4,485,808, 4,508,111, 4,538,600, 4,657,000 3,055,359, 3,928,872, and 3,799,159. These devices exert a force on a joint in a fixed direction. Some of these devices are adjustable in that the force can be increased or decreased. However, these devices are designed to treat either flexion or extension contractures separately, but not as a single device to treat both contractures. For these devices, a first device is fitted on the patient to manage a flexion contracture and a second device is fitted onto the patient to manage an extension contracture. The same shaped device can be used to treat either extension or flexion contractures; however, these devices are assembled during manufacture for either flexion or extension applications. Individuals having reduced mobility in both flexion and extension directions require two devices. These patients must be sent home with two orthotics. Insurance must cover the cost of two devices, suppliers must stock both devices and companies must manufacture two devices.
The present invention discloses an adjustable hinge splint that can accommodate both flexion and extension within a single device. Moreover, the device can be adjusted while on a patient to change from a device for promoting joint flexion to a device that promotes joint extension. This adjustment is patient directed. The patient is able to control and increase the tension on the damaged joint tissue. The device can be worn for brief periods each day, for several hours, or for longer periods, as recommended by the physician. Only one device is now needed to manage flexion and extension contractures. Patient directed management of the injury results in increased recovery rates and reduced visits to the therapist because a single device can apply tension to treat either flexion or extension contractures and either direction can be uniquely managed by the patient. This device decreases medical costs to either the patient or the insurer, shortens the time that the patient is away from the work place and as a result, decreases worker compensation costs. Further, this device can accommodate flexion and extension contractures in a variety of joints. This and other advantages of the present invention will be apparent from a review of this disclosure.